1. Discrepancies in current practice of pathological evaluation of sentinel lymph nodes in breast cancer. Results of a questionnaire based survey by the European Working Group for Breast Screening Pathology
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Maria Drijkoningen, G Fejes, Jocelyne Jacquemier, Peter A. Dervan, Fritz Rank, A. Reiner, Johannes L. Peterse, Werner Boecker, Jean-Pierre Bellocq, D Faverly, Janina Kulka, S. Thorstenson, E. Zozaya, Clive A. Wells, Brigitte Sigal-Zafrani, Thomas Decker, Simonetta Bianchi, Isabel Amendoeira, Roland Holland, Manuela Lacerda, A.M. Tanous, H. Kerner, Bettina Borisch, Ian O. Ellis, Anna Sapino, Päivi Heikkilä, Gábor Cserni, N Apostolikas, C. de Miguel, J. Martinez-Penuela, Peter Regitnig, C.E. Connolly, Vincenzo Eusebi, C. W. Elston, Cserni G, Amendoeira I, Apostolikas N, Bellocq JP, Bianchi S, Boecker W, Borisch B, Connolly CE, Decker T, Dervan P, Drijkoningen M, Ellis IO, Elston CW, Eusebi V, Faverly D, Heikkila P, Holland R, Kerner H, Kulka J, Jacqemier J, Lacerda M, Martinez-Penuela J, De Miguel C, Peterse JL, Rank F, Regitnig P, Reiner A, Sapino A, Sigal-Zafrani B, Tanous AM, Thorstenson S, Zozaya E, Fejes G, and Wells CA.
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Pathology ,carcinoma ,0302 clinical medicine ,sentinel lymph nodes ,Surveys and Questionnaires ,guidelines ,0303 health sciences ,medicine.diagnostic_test ,Micrometastasis ,Anatomical pathology ,Professional Practice ,General Medicine ,Immunohistochemistry ,nodal involvement ,3. Good health ,Dissection ,dissection ,030220 oncology & carcinogenesis ,Lymphatic Metastasis ,Practice Guidelines as Topic ,Female ,micrometastases ,SENTINEL LYMPH NODE ,medicine.medical_specialty ,Sentinel lymph node ,Breast Neoplasms ,BREAST ,Pathology and Forensic Medicine ,03 medical and health sciences ,Breast cancer ,breast cancer ,Biopsy ,medicine ,Carcinoma ,Biomarkers, Tumor ,Humans ,biopsy ,Clinical significance ,metastases ,030304 developmental biology ,Intraoperative Care ,business.industry ,Sentinel Lymph Node Biopsy ,questionnaire ,Original Articles ,medicine.disease ,Tumor microenvironment [UMCN 1.3] ,Health Care Surveys ,recommendations ,surgeons ,business - Abstract
Contains fulltext : 57809.pdf (Publisher’s version ) (Closed access) AIMS: To evaluate aspects of the current practice of sentinel lymph node (SLN) pathology in breast cancer via a questionnaire based survey, to recognise major issues that the European guidelines for mammography screening should address in the next revision. METHODS: A questionnaire was circulated by mail or electronically by the authors in their respective countries. Replies from pathology units dealing with SLN specimens were evaluated further. RESULTS: Of the 382 respondents, 240 European pathology units were dealing with SLN specimens. Sixty per cent of these units carried out intraoperative assessment, most commonly consisting of frozen sections. Most units slice larger SLNs into pieces and only 12% assess these slices on a single haematoxylin and eosin (HE) stained slide. Seventy one per cent of the units routinely use immunohistochemistry in all cases negative by HE. The terms micrometastasis, submicrometastasis, and isolated tumour cells (ITCs) are used in 93%, 22%, and 71% of units, respectively, but have a rather heterogeneous interpretation. Molecular SLN staging was reported by only 10 units (4%). Most institutions have their own guidelines for SLN processing, but some countries also have well recognised national guidelines. CONCLUSIONS: Pathological examination of SLNs throughout Europe varies considerably and is not standardised. The European guidelines should focus on standardising examination. They should recommend techniques that identify metastases > 2 mm as a minimum standard. Uniform reporting of additional findings may also be important, because micrometastases and ITCs may in the future be shown to have clinical relevance.
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- 2004